 I have a very good morning and welcome to the second joint meeting in 2022 of members of the criminal justice, the health, social care and sport and the social justice and social security committees to consider the progress being made in implementing the recommendations of the Scottish drug deaths task force. There are no apologies this morning and can I ask members to ensure that their mobile phones are switched to silent and wait for the sound engineer to put your microphone on before speaking. Our first item this morning is to decide whether to take item 3 in private, which is consideration of the evidence heard. Are we all agreed? Thank you very much indeed. Our next item is our second evidence session on reducing drugs deaths in Scotland and tackling problem drug use. I refer members to papers 1 and 2. I welcome to the meeting Mr David Strang, chair of the Scottish Death Drug Death Task Force. I thank Mr Strang for his written submission and I invite him to make some brief opening remarks. Mr Strang, I can ask you to speak for around three minutes. Good morning, convener and members. Thank you for inviting me to this session and for the opportunity to make a few opening remarks. Three weeks ago today, I was appointed to chair the task force, so I am new in this post, but the task force itself is not new. It has been going for over two and a half years and has achieved a great deal in that time. Scotland's drug-related deaths have rightly been described as a public health crisis or emergency. Every premature death as a result of drug use is a tragedy, a tragedy for individuals, for families and for communities. It demonstrates an urgent need to improve how we respond to this crisis and we need to change what we are doing. The task force's role is to examine the evidence and to make recommendations. Recommendations that will lead to reducing the number of people dying from drugs and to improve the health of people who use drugs. The task force has already achieved some major milestones. The availability and use of naloxone as an emergency response to save lives has made recommendations on drug law reform. It has developed the new medication-assisted treatment, the MAT standards, and it has published a strategy to tackle stigma that is associated with drug use. However, a great deal of work remains to be done to address the challenges that Scotland faces. Those challenges are not just for the task force, but for health services and the criminal justice system. Those challenges are for all of Scotland, whether it is Government at national and local level, partner organisations, businesses, third sector and communities. The new vice chair of the task force, Fiona McQueen, and I look forward to working with the task force members to continue this important work for the next six months. I would like to ask you a general question. You mentioned that you were appointed chair just a matter of weeks ago, and you outlined the role of the task force in gathering evidence and making recommendations and milestones that the task force was seeking to achieve. I am interested to hear your early views on, particularly, the remit in terms of reference of the task force. Do you feel that it is currently fit for purpose? Is the focus of the task force the right one? Perhaps a little bit about the time scales for delivery that have been set by the Scottish Government if you feel that those are achievable. A bit of a roll-up, but I am interested to hear your early views. Yes, thank you. It was through to go today that I was appointed. I chaired my first meeting of the task force the following Wednesday, so fortnight ago. That was the 19th meeting of the task force itself. The task force has been on a bit of a journey. It was launched in the summer of 2019 after the publication of the 2018 drug deaths. It was to run for the length of the Parliament, so its anticipated end date was in May last year, but it was extended, as you know, following the election to continue its work. It is a matter of judgment how much you include in a task force such as this in its remit. I am sure that we will get on to discussing this morning the focus on drugs. The topic itself is much wider than that, and I have already mentioned that it is not just an issue for health services and the police and the criminal justice system, but for much wider support and all arms of Government, national and local. However, it is reasonable that it has got a clear focus on, particularly, I suppose, because it is about reducing drug deaths. It is looking at people who are using drugs in a serious way and trying to stop them on a pathway to death. The focus is inevitably on things such as emergency response, support and treatment for people who are using drugs and trying to be effective in meeting their needs and supporting them. Now, there is a whole other agenda about prevention. How do we stop people going down that track? I am sure that the task force does that, but that is not the main focus. Our focus is on reducing drug deaths, so concentrating at that high end. We have a work plan, and we will be producing, as our final product in the summer of this year, a road map that will lay out what needs to happen over the next five years or so. The problem will not be solved in six months or in 12 months. We are talking about major cultural change in Scotland, and we are talking about reshaping services to support the needs of people who are using drugs and changing what we have been doing. The work, of course, will continue, but in terms of the remit of the task force, we will complete that and make our recommendations. The work and the recommendation and implementation clearly will go beyond the life of the task force. That is a helpful overview. Can I ask a quick follow-up question on where you feel the task force currently sits in terms of delivering on the task that it has been set? I would be interested to hear a little bit about your views on where you feel the task force currently is on that. I am really interested in what happens next. I have been looking through the reports of the task force over the past two years. There are over 100 recommendations, and that is the role of the task force. We are looking at evidence and making recommendations, so it is not our responsibility to implement them or to review them. However, I am interested in what has happened to those recommendations. Have they made a difference? Some of them were made as early as April 2020, so nearly two years ago. I would have expected to have seen some change as a result of that. That is a question that I will be asking. I do not know the answer to that, but I would hope that things have changed and that the recommendations of the task force will have led to improvements. If they have not, that will be something that we will comment on as we get to the final report and the road map to say that, if we have made recommendations, how well have they been implemented? Implementation is for others. Continuing beyond that, there needs to be some scrutiny and oversight to encourage implementation of the recommendations. I am just going to open up now to members. I am going to bring in Paul O'Cain, and then, after Paul, I will bring in Russell Finlay. Thank you very much, convener, and good morning to David, and welcome to the role. We appreciate that it is a fairly new role. I wonder if I could just follow on from the convener's last question, about the delivery of the recommendation of the task force and the scrutiny of whether that is being delivered or not. It is fair to say that it has been criticism from some people that the task force is, in itself, an advisory body only. However, you are feeling that it should have more power in terms of pressing stakeholders on delivery. What, indeed, do you refer to the scrutiny of that delivery and looking at whether things have been implemented or not? Is your view that there needs to be more power for the task force to follow up? I do not think that there needs to be more power for the task force because, in terms of delivering change, that has to be by existing institutions, organisations and structures. We are giving advice. We are making recommendations. We are advisory. Clearly, I imagine that the Government would not have set up a task force with a view to not listening to its advice and taking it on board. After the election, the task force entered phase 2. In the first phase, there were more operational funding projects and making decisions about research and so on, commissioning work. In the second phase, we are more looking at those projects and the results of the research and making recommendations. I know that the Government team supporting the task force and the whole drugs policy has increased and has a more active role in implementing policy. I know that some of the projects that the task force has kicked off will continue into next year, into 2023. That is what I meant. There needs to be a mechanism for still continuing to gather the learning from the projects that have been started and make sure that those are implemented. I am not arguing that the task force should have more power nor should it extend, but I am just saying that one of the questions that I will be asking is, who is now, how is that going to be overseen, whether it is by a different scrutiny body or a role for the Government itself? Thank you, convener. If I can, as a follow-up, I think that this is the first time that we have come together as committees on these issues. I think that this is very helpful. We are very keen, obviously, that the Parliament has a strong role in the scrutiny and delivery of the minister and the national mission. Obviously, the minister will be here after you. Do you feel that scrutiny by Scottish Parliament committees and perhaps this sort of forum is one of the avenues that we could take in terms of analysing those recommendations and tracking their implementation? Yes, I would be delighted if the Parliament did an active role in following up on the recommendation of the task force and seeking reports from Governments and others on what has been implemented. Perhaps more importantly, what has been the impact of that? Have services increased our drug users getting better treatment and care? What has been the impact of implementing the recommendation? I would welcome that role that you are suggesting. I will now bring in Russell Finlay, followed by Gillian Martin. Over to you, Russell. Pre-assessor Professor Katrina Matheson and her deputy Neil Richardson both quit saying that the Scottish Government's strategy was counterproductive. Have you had any contact with either of them? Have you evaluated their concerns? If so, what are your views on them? I do not think that I really want to comment on the views of my predecessor. If you ask your specific question, yes, absolutely. I have had a very good conversation with Katrina Matheson. We have talked about the work of the task force to date and what remains to be done, so I find that a really helpful conversation. I have talked a little bit in my answer to the convener's question about the timescale. I think that it is a matter of judgment. We will have been going three years now where the Government gets its advice from—clearly we are not the only source of advice—experts of the field as academic drug network and so on. We have a specific task to do, and we will do that and complete that by July. That will be the work of the task force, but clearly the work of tackling Scotland's drug problems has to be addressed by a wide range of organisations and official bodies, so it will not stop with the finishing of the task force work. The Rousdes task force has recommended the introduction of so-called tolerance zones. We heard that Police Scotland has concerns about them. What is your personal view? Do you support the task force recommendation? The task force is recommended that those be considered and examined. With a number of the recommendations, there have been quite radical new thinking, and I really welcome that. Now they have not gone into the detail of exactly what that would look like, but in terms of linking with, say, for consumption facilities, the strength of responding to drugs is to make sure that everyone understands what is being done and why it is being done. They are right to raise that whole issue about policing style and policing activities, to what extent does that support what is being done with drug consumption facilities or would it be counterproductive? Clearly, if you had a very heavy presence of the police who were searching for everyone coming near, that would be counterproductive and what would be the point of it. I have to say that Police Scotland is very involved in the task force. I know that you have heard evidence from a CCC assistant chief constable, Gary Ritchie, and in that evidence he is very supportive of the public health approach to responding to Scotland's drug crisis. I am confident that they will be very supportive of what we are doing and recommending. Thank you. Very quickly. It seems that tolerance zones would be around about any drug consumption facilities. Police Scotland has also expressed concern about them and the practicalities of those. Can you expand on what those might look like, how many there would be, where they would be? I am sorry, but were you asking about the proposed drug consumption facilities? The proposed drug consumption facilities, can you expand on how many of those would be needed, where they might be, in that kind of detail? No, I do not think that we have gone into that detail. This is a radical proposal. I have to say that, in my briefing form and discussions with the minister last month, he encouraged the task force to be radical and to push the boundaries of ideas. If you were to go down the road of safer consumptions, that would need to be a matter for local communities. It would be agreed in principle and clearly that all the legalities and practicalities would need to be worked out at a national level. It would be an issue that local authorities, local health boards and local police would have a view on. They are the ones who decide, rather than the task force saying exactly how many and where they should be. I am now going to bring in Gillian Martin, followed by Pauline McNeill. Thank you, convener, and welcome, Mr Strang, to your role. The task force, as you said, has put together many recommendations and they have been based on a huge amount of evidence and research that has been commissioned by the task force. As a result of that research and that work, do we have a clearer understanding of why we have got this particular Scottish crisis in terms of drugs death? What we know is that there is no simple answer to your question. It is a good question, as people ask. Why does Scotland have three and a half times the UK number of deaths? The last year for which we have figures is 2020. 1,339 people died drug-related deaths, which is over three a day. More than three people every day in Scotland are dying from drugs, which is an absolutely shocking and scandalous number. That is the highest ever. For the last six years, the numbers have been increasing year on year. In that last year, 78 young people under the age of 25 died from drug-related deaths. It is a crisis, but the answer to why is that the case is that it will be slightly out of the contested. It will be people with different views. It has been a long-standing challenge for Scotland. We know what the factors are that contribute, and they are well known that they will include things such as poverty and inequality, early abuse and trauma. It will be to do with mental health. There are a lot of common factors such as offending, homelessness, relationship breakdown, loneliness and violence. All of those things are associated and are linked. It is saying that there is not a single answer to why Scotland has such a high problem. It also means that there is no simple solution. We just did that one thing, that would solve it. It has to be in understanding what the underlying causes are. In fact, we need to have a broad response that addresses each of those. It is complicated and complex, as you just stated. Are we really at the point where we have to now be trying myriad interventions? As you said in previous answers to my colleagues, some of them are quite radical. It is learning from elsewhere where other countries or cities have had particular problems with drug deaths, where things have been tried and are yielding results that we need to look at. I was going to say that, but it is a good question that I have asked the team. I have said, well, where can we learn from elsewhere? That is a question that I am asking. Undoubtedly, we can learn from elsewhere. I know that the task force has done some work on international comparatis. Is it there for needing multiple responses? I think that the most significant shift in response that I have seen in recent years has been no longer seeing drugs as simply a crime and justice issue, but now seeing it as a health issue. In my opening comments, I was just repeating the words that I have held elsewhere, but this is a public health crisis, and that is the Parliament, and it is certainly the Government's position. I agree completely with that. I was at the police myself 40 years ago and it was thought that the solution to drug use was more law enforcement. It was about crime and punishment, and I think that we have a much greater understanding that dealing with it as crime and punishing people is—we have been trying it for 40 or 50 years—it clearly has not worked, but I think that even not just that sort of statement, but an understanding that it is a health issue, addiction is a health issue that you will not solve by punishing people, but they need care, they need treatment, they need support. Clearly, there is a role for the police that I am talking about—ancillary, crime, so if there is violence associated, or acquisitive, crime, theft and clearly drug trafficking. However, in terms of the very heart of people who are dying, because it is not the criminals who are dying, it is the people who are suffering addiction, and therefore the solution needs a change of attitude to seeing drug problems as a health issue and not a crime issue. I am now going to bring in Pauline McNeill, followed by Miles Briggs, over to you, Pauline. Good morning and thanks for the work that you are doing. I wanted to ask you this question about a continuation in the law reform issue in relation to the review of the 71 act with the possibility of creating safe consumption rooms to prevent death. I note that you said earlier that it is important to explain to people what we are doing in any reform. I hosted in 2018 Nana Gorffydd in a street lawyer from Denmark, who led the charge in the Danish Parliament to change policy in safe consumption rooms. She is very much behind what is going on in Glasgow. However, having researched it, there are 66 cities where apparently there has been no death and no evidence that there is increased drug use. My first question is, do you think that it is important to have credible evidence on this so that we can decide whether it is evidence that we can use or not to make a judgment on whether this is one of the tools that we could use to talk death? The task force has recommended that it is safe for drug consumption, so it has been set about. Obviously, it is not in my time, but they were satisfied that there is sufficient credible evidence, so that is the recommendation. I agree with that recommendation. You are a wider point about whether we are going to try to change public opinion and political views and get political buy-in. I think that credible evidence is really important, and that is at the heart of what the task force has been doing, is looking at that evidence and using it. Of course, I have given evidence to committee of the Parliament before, and you hear people say that that might be the evidence, but I do not believe that. I think that it is still right to a lot of people. People are not necessarily persuaded by the evidence, and I was struck by lots of the emergency implementation or changes that have been made because of Covid. There was no evidence of the impact of the vaccine for five years, because it was just not available, but it went ahead and did what had to be done. I am not in any way minimising the need for evidence, because I absolutely believe that evidence is very helpful. However, we have lots of evidence for the recommendations that the task force has been making. I am slightly reluctant to agree that we need more evidence, because I think that the evidence is overwhelming for supporting drug consumption groups. Yesterday, we heard from the minister, Kit Malthouse, and we had an exchange in a number of us on the same subject. What he had to say was that it is very complex, but as you know, our Lord had to consider this question. He has already been consulting with police and so on. Kit Malthouse said, if we set up an overdose prevention site in Govan, would you arrest someone who was travelling to Govan from Edinburgh? It is quite a simple answer to that. Obviously, you have been a former chief constable, so you have seen us in Glasgow. We had tolerance zones for what was then called street prostitution. It is not as complex in my mind if you set up a zone in which you would supply the law, so anyone outside that zone would be breaking the law in order to make sure that we direct people to the... Is it your view that it is too complex a question? I know that you support the setting up of them, but the minister who is in charge of the 71 act, if you like, is saying that it is really complex, and I am not sure that I agree with that. I mentioned travelling from Edinburgh and from Bezzden, so that is two places that I have lived, so there we go. No, I think that it is always possible to... I think that a lot of people can find reasons if they oppose something, and I do not think that it is as... Or whatever challenges there are to implementation with the police working with the Crown Office, they will come up with a working solution. You can imagine that if there was a zone where people were not going to be searched and detained for possession, you could imagine, oh well, will drug dealers then move in and start dealing drugs in that area? If that was happening, it would get picked up very quickly, and the police would intervene. It is not a free-for-all and encouragement to drug dealers, so whatever practical objections or challenges there are, I think that those are entirely able to overcome those. The point is that doing so will save lives. That is the thing. It might reduce the number of people being arrested, but if it saves lives, I think that that is the win-win on both hands. I am now going to bring in Miles Briggs, followed by Eleanor Whitham. Thank you, convener. Good morning, Mr Strang. Thank you for joining us this morning. I wanted to touch upon a few issues with regard to community pharmacy Scotland's role in the public health crisis, and you specifically highlighted Naloxone's inoperating statement. In terms of some of the work that was meant to take place around access to single records for individuals, why that has not happened? I need to say that that is too detailed a question for my level of knowledge at the moment, but I am very happy to get an answer from the task force for you. I do not know the answer to that specific question, but I know that one of the things that the task force has commented on is the role of the pharmacy and whether there should be a relaxing of some of the restrictions that are on some medication so that it can be more easily. I think that the whole thing about Naloxone being given into the hands of families of users. I know that the nasal application is seen as more user-friendly than a needle in injection, but that is a sea change in the past five years of having relevant medication close to where it is needed. That is helpful. I will take up that detail with the minister in our next session. It is important that the Naloxone programme, which all of us support on that call, has not gone where we wanted it to. Part of the work and frustration around the task force has been that some of the key recommendations that were accepted do not seem to have happened. I fully understand that you are new to that role, but I wonder why you think that that has not taken place in the discussions with community pharmacy. I absolutely want to hear from community pharmacy, because they have a key role to play. As I said in an early answer, one of the tasks that I have or have asked for is an update on the 100-plus recommendations and what exactly has happened. At the last meeting of my first meeting of the task force, we had a presentation from the police supported by an evaluation by an academic of the Naloxone pilot. There was a pilot last year at three different sites where police officers were carrying, were trained and carrying Naloxone. I think that the results of that evaluation are due to be published soon, but I know that over 50 uses were made of Naloxone. I think that there was a sense that 56 lives potentially had been saved. I think that the overwhelming result from that pilot will be that it was successful and there will be a further roll-out across Scotland of that. That is helpful. Any information that you could provide us with details of what that looks like would be very helpful. I want to move on to the role that you touched upon in your opening statement with regard to addressing stigma and trauma-informed services, and specifically with regard to local government. There are concerns over budgetary pressures and where the recommendations of the task force and the work of local authorities in trying to turn around this public health crisis have not been necessarily taking place. I fully accept the pandemic pressures that we have seen, but why do you think that that has been and are you concerned given the concerns that we have seen to local council budgets that the issues that we need to see addressed by local authorities, housing being one of the key issues often, and that will not necessarily take place? How will the task force try to recommend that that is given the priority that it so willingly needs? We asked about stigma. We found that stigma prevents people from coming forward for services and even some very disappointing stories of the way that they have been treated when they go to services. There is still quite a punitive view that this is a choice that you made. In a way, unlike other illnesses where people are treated with compassion sympathy, often people are blamed to your fault, they are not trusted, they think that you will be dishonest, and there are more deserving cases. It reminds me a bit of our attitude to mental health problems. As you know, I chaired an enquiry into mental health services in Tayside. It was interesting how often we heard from people who were in mental health services and there is an overlap with substance misuse services who felt that they were not taken seriously, that somehow they were attention seeking, they were not deserving patients, whereas if someone has a heart attack or a broken leg, they are a deserving patient. Stigma is important and is a barrier to tackling the issue. I would be interested if you mentioned housing because that would be a homelessness. I said that there was a factor, I do not know whether it is a cause or a correlation, but anyway it is a factor for people with mental health and substance abuse issues. The lesson for this is that we cannot treat all those problems as a single issue. A council will have a housing policy and a health board will have a mental health policy, in some way you will find a substance use policy and you will have a trauma informed policy. However, those will not deliver, so that is why we need to look at the whole person and say, well have they got the housing issue? Can they get into employment? Where are their support mechanisms? Your question about what more could be done is not over 1,300 deaths a year, enough motivation to free up some budgets. I understand your question and how we organise local government is that we give money for housing, we give money for health, we give money for education, but the challenge for people who are leading and making decisions on those issues is about this person. What do they need and need to make sure that that is joined up? I suppose that my experience of that was from people coming out of prison. Often they will have needs for medication, for accommodation, for benefits and we require them to be in three different places on the day of liberation. We need to get much better at joining up support for individuals that cuts across those traditional funding mechanisms. I am afraid that I am going to have to jump in. I have been very reluctant to do that, but I wonder if we can come back to you, Miles, if there is time at the end. I am just keen to keep to time so that everybody can come in. I am now going to bring in Eleanor Wittam. Thank you very much, convener, and welcome to yourself, David, on your role. We do know that there are strong links between poverty, deprivation and inequalities and problem drug use. In Scotland, we can trace that back to economic policies from the 1980s. At this point, we are seeing that it is people who grew up in those in this period, in their late 40s and early 50s, my cohort, my age group, living in deprived areas who have the highest risk of drug deaths. How crucial do you think that the Scottish Government's anti-poverty work is in tackling the drug deaths crisis? Do you recognise the need to work right across policy areas in government departments, local authorities and the third sectors? Have you touched a bit on that? I agree with the question that you are asking, and you are right about that sort of middle-aged men. I feature highly in the drug statistics. I have to say that the number of young people dying drug-related deaths is increasing. There were 78 in the year of the last figures. It certainly is that cohort that you are relating to, but it is also young people as well. For me, the longer-term solution, the focus on prevention, is absolutely tackling those issues that you talked about in terms of anti-poverty, reducing inequality, providing more opportunities and providing support for people who are traumatised and brain injuries. Another feature of the young men employment is the level of brain injuries that others in the population have five times more. There are a number of factors that we absolutely need to address in a joint-up way for long-term prevention of drug problems. I am also applying it to the treatment and care of people who are at risk of dying. A much more immediate short-term issue is that services also need to be joined up for. Tackling poverty will not save someone's life tomorrow, but our services absolutely need to be joined up. We need to join up housing and benefits and welfare and care and so on so that people get the support that they need. The answer to your question is both in the short-term to save lives but, if we are going to make a major impact in the longer-term on prevention, we need to be joined up right from the beginning of someone's life. Sorry, can you hear me now? I can hear you now, yes. Thank you very much for that answer. I want to revisit something that my colleagues Miles Briggs has just brought up and that is about stigma. We know that stigma is a huge driving force that drives people away from services. Having previously worked for women's aid, supporting women fleeing domestic abuse and many facing addiction issues born out of the issue of self-medication, the stigma and fear that they had with regards to losing custody of their children not only due to the abusers' actions but also due to bringing their addiction to the light, letting it be known that they had the addiction, that fear was palpable. How can we address stigma and the harm that it does cause? A true public health approach to me, surely, must not seek to re-traumatise nor stigmatise. As we think as well, people who are perhaps stopped for simple possession, who then might find themselves incarcerated for a period of time, etc. Again, a true public health approach should take a different path. Is that what the drugs theft and death task force actually believes as well? I spent five years as a student inspector of prisons for Scotland and our prisons are full of people who have addiction problems and poor mental health. We have one of the highest rates of imprisonment in Europe. Again, I would say that it is not working. Going down a crime and prosecution and incarceration model is not reducing the drug deaths and the drug problems that we have. I was hearing from someone recently who was hidden in his history when he was using drugs and wanted some help. I went to his GP and said that this is getting too much. I want some help. The first question that the GP asked him was, do you have children? Of course, we should be concerned about children and child protection, which is hugely important, but that communicated to him that the stigma that is associated with that was an immediate barrier to someone coming forward for help. I entirely understand that that is a factor that needs to be taken into account but not as the first question when someone walks through the door to ask for help. What are your views on a community justice approach, a smart justice approach? Do you see that as being a soft touch justice or a crucial part in how we tackle the crisis that we are facing? In 2007-08, I was a member of the Scottish Prisons Commission that produced the report Scotland's Choice, which recommended the abolition of short sentences. I have been entirely consistent over more than a decade in arguing that that means that you are much smarter and that particularly short term imprisonment in most cases does more harm than good and we need to be much more creative about how we respond to offending behaviour and harm. I am not saying that we should do nothing, but it is not about being soft. Community sentences have potential to be much tougher than an easy stretch in prison for people who are in and out of jail the whole time. It is not a deterrent, obviously, but it is self-evidently not a deterrent. Similarly, I know that on the diversion from prosecution, there is evidence that that is much more likely to lead to someone getting the support and help that they need rather than being prosecuted a period before the sheriff and being sentenced. I have to say that the police and the Crown Office have been very supportive of that and that is part of the work that the task forces do. I am going to hand on to Gillian Mackay, and I will then bring in Sue Webber. If I can just ask for questions and answers to be as succinct as you can make them. Over to you, Gillian. Thank you, convener, and good morning, Mr Strang. It is clear from the joint committee evidence session with Kit Malt house MP yesterday that the Scottish and UK Governments take a very different view with regard to the causes of drug use and how it should be addressed. What impact will that have, in your opinion, on the two Governments working together on drug-related deaths, and what, if any, changes need to be made to improve partnership working? I do not know the answer to your question as to what impact it will have on Governments working together. I would hope that on as serious an issue as this, that there could be perhaps behind-the-scenes negotiations to get a satisfactory solution. We are the Scottish drug task force and our remit is to try and change attitudes and actions in Scotland. I do not think that our remit extends to persuading London to change what they are doing. I have been understanding entirely your question. I heard Mr Malt house's evidence yesterday, and I think that the emphasis on heavier policing as being a route to tackling our public health crisis is not the right way forward. We have tried that for 50 years and this is where we are. I would hope that there can be sensible negotiations between those places. I know that we are exploring what can be done in Scotland on the current legal framework. People are being as creative and constructive as they can be. I am not insisting that the UK Government changes its policies on what happens in England and Wales, but if something could be negotiated that makes what we are advocating more likely in Scotland, that would be very helpful. I managed my supplementary question, which is going to be about whether we need a change of policy from the UK Government to make things easier. I will hand back to you just now. Thanks very much indeed. I thought that you would have still tried to get another question in there, Gillian. I will now bring in Sue Webber, followed by Faisal Chowdry, over to you, Sue. Thanks, convener. Earlier on, colleagues have spoken at length about the need for radical interventions and learning from elsewhere, but I am really concerned with that. I think that we should be looking far closer to home and what is working well in Scotland right now to save lives. My colleague Miles Briggs mentioned naloxone. I will representations from the Royal Pharmaceutical Society this week around the current lack of consistency in the naloxone and a lot of the issues. Should we not be looking at accelerating and embedding services that are doing well and saving lives now in Scotland that are not provided across the country? Will we not see that as a priority? Absolutely. I have mentioned a pilot of naloxone that was carried by the police that we considered at the task force. I know that we will be making recommendations about wider roll-outs of naloxone, and that is part of our discussions with community pharmacy. I do not think that it is a choice. I do not think that it is either we look to other cities internationally and do what they are doing or implement the good things that we know of work in Scotland. We have to do both. There are lots of good things that are happening in Scotland, such as the recovery network, the peer mentoring, the navigator's work, the pathfinder up in Inverness. I think that there is a lot of work going on and family support. Often, those are not officially run by Government authorities but support networks and local initiatives that provide support. One of the important things that you have raised is the inconsistency of service across Scotland. I do not know whether that is a feature of having many geographic health boards or 32 local authorities. Depending on how you look at it, if you like local flexibility, you are in favour of that variance because it can match the local need. However, you can then describe that as a postcode lottery. Why, in one local authority, can you get this disposal from code or support network and somewhere else you cannot? It is not a straightforward question to answer as to whether you want absolute consistency across Scotland or whether we should allow flexibility. I want to ride both horses and say that we should have consistent services for what people need, but I recognise that service requirements in Glasgow will be different from those in Shetland. Yes, indeed. It is taking that short-term approach and trying to replicate and take on what is working well to address the short-term crisis that we have, but I am also glad that you alluded to some of the services that are provided by the non-government agencies. The third sector is key, so I was wondering if you could comment on how we might be able to help those third sector organisations that are carrying much of the burden and have done so throughout the pandemic in terms of financing and giving them the longevity and the security of funding that might happen around that angle. One of the things that we should be doing is listening to them. I know that they have been represented on the task force and we have some subgroups that the third sector is working on. Part of our early programme as chair and vice chair of the task force, Fiona McQueen and I, is visiting some third sector projects to learn more and to hear what they have to say. I think that we ought to extend that more widely in terms of developing drug policy. We should be listening to people who have lived this and know what it is about, listening to their families. In fact, the task force has three people who are representative of groups that have experience of supporting someone with a drug problem or have themselves. I agree with you that we should be hearing their voice and we need to support the third sector because they have an important part to play. Can I get another question? Is that okay? Very quickly, Stu, if you don't mind. Of course, I'm a bit curious. Mr Strang, it's a bit different subject. I'm talking about the issue that we've got right now. Is the task force specific to looking at the role of cocaine in the drug-related deaths? Do we get a sense of the treatment options for cocaine and are Scottish services sufficiently skilled in addressing those issues that are coming to be much more prevalent and important in those drug-related deaths? What I'd like to respond to in more detail is that cocaine is not appearing highly in the toxicology for drug deaths, but I don't want to just give a quick answer to that. I'll make sure that you get a proper answer on that issue about cocaine and treatment. I'm going to quickly move on to Faisal Shoudry. If we've got some time, I can open the session up to a couple of supplementaries before we finish. Faisal, over to you. Faisal Shoudry, David. Good morning, David. Nice to see you in your new role. I've only got one question for you. The national record for Scotland homeless death publication for 2020 showed that over half were drug-related. There were 151 homeless drug-related deaths from 1968 in 2017. In 2020, homeless drugs-related deaths accounted for 10 per cent of all drug-related deaths reported in the NRS 2020 annual report. Can you confirm what action has been taken to reduce homeless drug-related deaths and ensure people who are homeless and suffer from drug-related harms can access key support services, including drug treatment services? What is being done to reach out to this population? Mr Strang, before you come in, I'm just not completely sure that that question relates completely to the work of the task force. It's a very legitimate question, but it is a much wider question, in my view. I'd like to highlight to members about making sure that questions remain on track. I'd like to respond to it, because it has a link with the drug side. I suppose that your question is illustrating my point about that. We can't deal with those with single issues, because people who are living—homelessness is wider, definition is just rough sleeping—but people who have a housing need, and you're talking about people who are also with substance misuse treatment needs, often will have mental health needs. What we need to do is to make sure that we join up those services so that that one person has the support that they need. They don't need to go to three offices at three different times for appointments that they probably won't keep. I think that there are a lot of initiatives, things like street work and other people who are providing support to people who are rough sleeping. In Edinburgh, there is a GP access point that is supporting people who are homeless. I think that you raised an important issue that we do support the wider needs for food and accommodation needs. I support the thrust of your question that these services need to be joined up and provide a whole-person approach to supporting them. Thank you very much indeed. We've got a little bit of time in hand, so Miles Briggs, I'm happy to bring you back in. I did cut you off a little bit earlier on, so if you'd like to come back in. That's great. Thank you very much, convener. I appreciate that. I was taken with what you said earlier, Mr Strang, with regard to your work around mental health support in Dundee and the inquiry that you undertook there. I wanted to ask specifically whether you would support a legal right to rehabilitation for people in Scotland around the issue and whether that is a piece of work that the task force will start to look at. It's very important, as you highlighted, that we make sure that people have the right to access these services and that people can take decisions for themselves and drive their treatment. I just wondered what your view was on that. I think that the central thrust of what you're saying is that I would agree that people should be consulted and have some sort of a choice in how they're treated. That's the way that health services have moved that people, rather than the doctor always knowing what best, but she will now ask you what your views are on that. Those are the options, and the decision-making about someone's care tends to be much more of a joint decision, rather than the doctor simply saying that this is what you need to undertake these tablets. The same should be applied for people who have health needs as a result of addictions. They should be involved and engaged with families as well, if that's appropriate. Of course, everyone should get appropriate treatment. That goes without saying. Isn't that a basic human rights act that people have a right to receive the treatment that they need, and that they should be consulted on and treated with respect and dignity? For my experience, speaking to people who have access to mental health services and people who have access to drug services, they don't feel that they are respected and listened to. They don't think that their voice is heard. I've heard complaints of people being over-medicated and that they want a different route, but that was all that was offered. I do think that we have a way to go yet on treating people with dignity and respect and engaging with them in discussing what their treatment needs are and to support them in delivering those. I'm going to bring Elena Whitham back in for a follow-up question over to you, Elena. Thanks very much, convener. It's just a brief question surrounding those paper-consumption facilities. We heard from Minister Ketmol that the UK Government is still not convinced that it's public health use. What are you feeling round about that? In my experience, that is the gateway to accessing services from people who are afraid to reach out in another way to be signposted in a setting where they are going to be looked after and kept safe and kept alive if something terrible does happen. It's just to gather your thoughts on that as a public health safety measure in terms of the whole basket of measures that we are going to be needing. The evidence is that once people are in services, they are less likely to die. We should be doing all that we can to engage people in services. I don't know enough about the actual workings of safer consumption facilities, but if those are places that are clear for the point of view of safer injecting and so on, that's a health benefit. However, if it also encourages people and enables them to be referred to services and be supported, that's positive. I think of two other settings where things have changed in recent years. One is that, in the criminal justice system, where someone is detained at a police station, often there will be a navigator scheme or a rest referral scheme. If people have alcohol or drug addiction problems that they want support for, that can often be a trigger point. Similarly, if people go into prison, that often can be a time when, if they've ignored what treatment they needed beforehand, that can open up a door. In hospitals, if someone goes into hospital, not because of their drug use, but because of other reasons, that can be a point of contact. It's any point of contact with any service to be an avenue for someone who has problematic drug use to get into treatment and services. We should try to do that in all services. I'll finally bring in Julian Martin, and then we'll bring the session to a close. Thank you. I'll keep it very short. Yesterday, I asked Minister Kit Mulhouse about his response to one of your recommendations about consumption facilities. In the response, he said that he might give the impression that they condone illegal drug use and that those facilities might become magnets for drug dealers or even encourage people to take drugs. I just want to know what your response is to that kind of response from Kit Mulhouse and the UK Government on that. I'll keep my answer brief. For me, it reveals a mindset that drug use is about criminality. We're very encouraged—we need to talk about encouraging crime. The argument for them is about tackling Scotland's public health crisis. People who are addicted are unwell and they need medical care and support and treatment. That's nothing to do with encouraging crime. Thank you very much indeed. I'll bring the session to a close. I just want to pick up David MacDonald's one point that he raised in relation to the implementation of the task workforce recommendations. He would be looking for an update on those. I wondered if it would be possible for the update to be shared with the committee. It would be really interested to know—or the committees—a little bit about that. If that would be possible, that would be appreciated. In the meantime, many thanks for attending. It's been an interesting session. Obviously, if members have additional matters that they'd like to follow up on, we will do that in writing with you. Many thanks again. We'll take our short suspension now before we hear from our next witness and reconfine at 11.15. Welcome back again, members. I now welcome to the meeting Angela Constance, Minister for Drugs Policy, Dr Maurice Brazer, Head of Delivery and Support Unit of the Drugs Policy Division and Henry Aker's team lead at the drug deaths task force support team of the Scottish Government. I thank the minister for her written evidence and invite her to make some brief opening remarks. Minister, you have around about three minutes. Thank you very much, convener, and good morning. I'm very grateful to all three parliamentary committees for coming together and joining up and working across portfolios and for the opportunity to update committees on the actions that we are taking to implement the recommendations of the Drugs Death Task Force. I would like to start by saying that every life lost to a drug-related death is unacceptable and I once again offer my condolences to those who have lost a loved one and give my continued commitment to work across Government, across Parliament and beyond to save and improve lives. I do want to once again take the opportunity to put in record my gratitude to the task force for their work to date. Their focus on evidence-based recommendations has helped to inform our response to this public health emergency. I would emphasise that the work of the task force sits within the context of a wider national mission and we will consider its recommendations in line with those of our other expert groups, too. The task force has supported a wide range of innovative tests of change. Those projects undoubtedly have had a positive impact on their localities, where they have operated. The focus now is on learning from those projects, rapidly expanding and rolling out what we know will make a difference. I very much believe in evidence-based policy making and I am committed to following the evidence as it emerges. I have taken on board all of the task force's recommendations to date and I am working to take them forward. The map standards are a prime example of that. The standards set out what people should expect and can demand of services and implementing them across Scotland will give people access, choice and support through services. Through partnership with the task force, Naloxone is now more widely available with distribution to the Police and Scottish Ambulance Service, as well as expanded family and peer-to-peer distribution. Since the start of the Police Scotland test of change, 53 lives have been saved by police officers. The task force recommendations on stigma are also crucial, as we know that stigma is a barrier to access and support. Following those recommendations in December 2021, we launched a national campaign to tackle the stigma associated with substance use, highlighting that drug and alcohol problems are a health condition and those struggling with them should receive support, not judgment. Many of the changes that are needed have been talked about for decades, but not delivered. Ultimately, it is the impact of implementing the task force recommendations as part of the national mission that really matters. That is why I am acting quickly to accelerate delivery and why I have asked the task force to provide their final recommendations by July this year. I recognise that that presents an additional challenge, but I am confident that, with the experience of David Strand and Fiona McQueen, they bring to the task force that this ambitious goal is achievable. I look forward to discussing implementation to date, the next steps with committee members, and I know that we can work together to tackle this public health emergency. I would like to kick things off with a general question, if I may. Obviously, there has been on-going focus and scrutiny of the task force and the wider work of the national mission, as you outlined, and the delivery of the task force recommendations. There has been some focus around the timescales that you spoke about just towards the end of your statement. Are you satisfied that the task force is on course to complete its work within the timescales set, or if they need to be reviewed, or perhaps they should be reviewed at any point down the line? That is something that I have discussed with the new leadership of the task force and the task force membership more broadly. I am confident that the task force will produce its vital recommendations by this summer. Obviously, the Government is actively supporting the task force in its work. There is a team of civil servants who support the task force with secretariat tasks, etc. It has always been the case that we will need to look after the legacy of the task force work. There are some tests of change that will not be complete, but they would not have been complete by the end of this year, the original timescale for the recommendations by the task force. Arrangements will have to be made. We will make those arrangements in consultation with the task force and the other to ensure that we continue to learn from the evidence as it emerges. I am very clear that I am committed to evidence-based policy, but I am also clear that we cannot wait for evidence being complete because evidence is never complete. We have to take what we know, implement it and be prepared to adapt and change as we move forward. A quick follow-up question, if I may, on that point of evidence, and you spoke earlier on about following the evidence and the importance of that, earlier on in our session with David Stran, we spoke about, and I think that it was in response to a question that Sue Webber asked, was about looking at that wider context, perhaps international context, but also looking closer home. Certainly, Mr Stran felt that we should be doing both. Would that be your view as well? Absolutely. International evidence is crucially important because there are other countries, many of them, around the world that have a far lower drug death rate in Scotland, so we absolutely should be looking at the very best of practice within Scotland across the UK, but also internationally. We have a lot to learn, and I make no bones about that. Thank you very much indeed. I am just going to move straight on and open up questions, if I may. I am going to bring in Paul O'Kane to begin with, followed by Russell Finlay. Over to you, Paul. Thank you, convener, and good morning to the minister. I will follow up on a theme that I spoke about when I questioned Mr Stran. It really is, I suppose, the role and the purpose of the task force. It is fair to say that there has been criticism that the task force initially regarded itself as advisory only. Mr Stran reiterated some of that position, but acknowledged the fact that there will have to be a mechanism for the task force to review work and to come back. I suppose that, to ask the minister, does she think that that criticism is fair? What further does she think needs to be done in terms of being able to drive forward the task force recommendations into action? I do very much concurred with the view that it is Government and institutions in this country that have to implement changes. It is imperative, as part of our democracy, that we are guided by Parliament, scrutinised by Parliament and parliamentary committees, but notwithstanding that, there is also a role for external organisations and experts in various fields, in particular in the lived and living experience community, as well as academics and people who are providing services on the ground. In terms of the task force, yes, its remit changed when I came into this post. The task force had been in operation for 18 months when I became minister responsible for drug policy. At that time, I was very clear about two things that were missing or needed corrected. One was that drug policy should not be seen in isolation and that it absolutely had to be connected with every other Government portfolio. Drug policy needs to be joined at the hip, with justice, housing, homelessness, mental health, primary care, education, prevention, poverty and inequality. That is a far bigger job than that of the task force. If there was, and I am aware from my very early engagement with some stakeholders and various party spokespersons in MSPs, there was concern about how the Government was performing in relation to tackling drug deaths and there were concerns in and around the task force. My view was that the Government had outsourced its responsibilities and that I would not be doing that. I wanted to support the evidence-led work of the task force, but that any criticism of the task force should rest rightly with the Government and not the task force, which is comprised of individuals and citizens who were given of their time and talents to work with the Government. Yes, there was that refocusing of the role and remit of the task force. Thank you, minister, for that response. We are all keen to ensure that any parliamentary scrutiny is at the heart of that. You may have heard my follow-up on ensuring that committees of this Parliament particularly have a laser focus, if you like, on those issues. I think that, clearly, what you are saying is that, as minister, you are keen to engage in that scrutiny and not, I think, outsource the work that you used in relation to the national mission. Obviously, I have said this in chamber as well about ensuring that we have a regular opportunity around scrutiny. I do not know whether the minister can be outlining how she would see a committee like this joint committee operating going forward. Is there something that she would welcome in relation to the scrutiny of the task force and, indeed, the overall work of the national mission going forward? It is, of course, not for a Government minister to be in any way indicating to committees how they should proceed with their business. What I will say is that I very much embrace that, although it is not always comfortable, it is absolutely necessary. I can assure you that it always leads to better outcomes. I do welcome the joint-up approach that is taken by the three parliamentary committees that are involved today. It is reflective of the work that we are embarking on in Government to ensure that, as I have said, drug policies are joined at the hip with other crucial public policy and not seen in isolation. It is also what we are trying to get our services to do in communities to have that joined-up approach. I very much welcome that. There is a role for parliamentary scrutiny of the Government, of the drug stress task force, the residential rehabilitation group, how we implement MAT standards, the national implementation group and, of course, people will be really interested, I am sure, on the new national collaborative as well. The national mission is, of course, bigger than any one single group. There is a lot to scrutinise and there is a lot to engage in. Thank you very much, Paul. I will move on and I will bring in Russell Finlay, followed by Gillian Mackay, Russell Finlay. Yesterday, Kit Mulhouse spoke passionately about the need to support those with drug problems, but also about the vital role of the criminal justice system. He spoke about, for example, a ring of steel being put around the community of Blackpool as part of project adder. We know that every single day, Police Scotland and the National Prime Agency work hard to target the organised crime gangs that make so much money from killing people in Scotland with their products. As the question is, do you agree that it is not one or the other and can you give a commitment to Scottish communities that they will enjoy robust policing and targeting those who deal in drugs? I am grateful to Mr Finlay for that question. It highlights the important role that police have in upholding the law. He may be aware that there is a serious organised crime task force, and much of what he describes is very firmly in the remit of the Cabinet Secretary for Justice, and nobody would demark from the importance of trying to interrupt the supply of drugs or, indeed, to bring those who pose the greatest risks to individuals and communities to justice. I would say that, from my perspective to Mr Finlay, I am looking at the evidence that, again, from across the world, we know that more punitive approaches and where our criminal justice system is solely focused on enforcement can add additional harms and add barriers to treatment. I do not know whether he is aware of the work of the Conservative Drug Policy Reform Group, which produced some interesting findings recently, and it spoke about how it is important that different policies do not work against each other. Therefore, it is important that policing in our criminal justice system operates, so that that does not become a barrier to people's access and treatment and that it does not add to the harms that people are already experiencing. I also think that there is more work to do in terms of engaging communities with what will make them safer at the end of the day. Treatment and ensuring that people have access to better and quicker treatment is a huge part of that, and that a public health approach—again, all the evidence would point to that—is better for smarter justice in our community but also in terms of making our communities and individuals safer. Many prisoners are unable to break their addiction due to the high levels of drugs in prisons, and indeed some prisoners go into prison without a drug problem and leave with one. Do you think that we can ever get close to eradicating drugs in prisons, and perhaps immediate steps can be taken to do something about it? In terms of things such as RappiScan scanners, Mr Finlay, I am sure that we have discussed those matters in detail with the Justice Secretary. The safety and wellbeing of prison staff and prisoners is of utmost importance. It is reflective of what we know about the wider community. We know that we cannot arrest our way out of a drugs death crisis. Therefore, it has to be about addressing the root causes of people's substance use. It has to be about that bigger, broader agenda around homelessness and poverty. It is also about ensuring that people have access to treatment and treatment that is right for them. Access to treatment and support is crucial in our prisons in relation to healthcare. There is a very important survey of prisoners' health and social care needs that will be complete by spring, if I recall that correctly. There is important work going on led by the recovery community within our prisons. I visited a number of recovery cafes. We need to be focused on addressing the needs of individuals. There are also broader issues about overcrowding in prison, and our prison population—I think that most commentators would feel if the view is too large. Last September, the Cabinet Secretary for Justice told the Criminal Justice Committee that I will quote prisoner governors in England and Wales that it is not possible to have a drug-free prison. I would like to test that to see what extent it can be achieved. Is that realistic? I am not going to contradict the cabinet secretary for justice. Where I will routinely provide a challenge to my colleagues is what more can we do to ensure that people have access to treatment and support to address their use of substances. I am very clear that, as we are working to implement the Medicational Assisted Treatment Standards, for example, those also have to apply in prisons. I think that a key part—it is not the only part, but a fundamental part—of improving lives and saving lives is ensuring that our prison population gets better access to healthcare, and that includes drug treatment as well. I will now hand over to Gillian Kye, and then I will bring in Eleanor Whitton. Gillian, over to you. Thank you, convener, and good morning to the UK Government's two non-saint assumption rooms. Is the minister confident that there is still a way forward for Scotland to launch a pilot? I am, Ms Mackay. I do not think that I caught all the question there, but I am sure that it is about our work around safer drug consumption rooms and something about Mr Malthouse's evidence yesterday. It is a matter of public record that work is going on with reference to a pilot for a safer drug consumption facility in Glasgow. A proposition has been brought forward by the health and social care partnership in Glasgow for that pilot, and there is extensive work going on between Crown Office, Police and our local partners in Glasgow. I note that Mr Malthouse and I come from a different position on that. I am very strongly of the view that there is no dispute in the evidence. The safer drug consumption facilities can save lives. I will, of course, reference committee to the evidence paper that the Government produced not that long ago, and I am sure that it will be shared with the Justice Committee at the time. I have also shared with the committee an exchange of correspondence between myself and Mr Malthouse. I think that he sees more problems than I see. There are undoubtedly issues that need to be resolved, and that is what we are actively engaged with. There are three avenues to pursue drug consumption facilities. The UK Government could, of course, introduce primary legislation. In a way that Ireland did a number of years ago, it could, of course, devolve powers to Scotland and enable us to introduce legislation. The third option is that we pursue what we can with our own powers to bring forward a proposition that is clinically and legally safe for both those who use the service and who work in the service. It is delicate work, detailed and, yes, it has its difficulties, but that work is progressing. We are absolutely committed to doing everything that we can where possible with our powers to implement evidence-based interventions that save lives. Julianne McLean, do you want to come back in? Yes, just briefly, convener, thank you. Malthouse said in his evidence during the joint meeting yesterday that he did not recognise poverty as a driver of drug use and that drugs and violence drive poverty. I am deeply concerned about the apparent equating of drug use with violence in the UK Government's belief that poverty does not drive drug use. There is a clear conflict between the Scottish and UK Government's understanding of the cause of drug use. What impact will that have on the UK and the Scottish Government's ability to work together on the issue and how will it impact efforts to tackle the stigma surrounding drug use? It is no secret that we will have different views on, in particular, harm reduction interventions, and we will have different views about the lens that drug use should be viewed through. I recognise the role and relationship of poverty and other matters. There has been a lot written and published about the impact of very concentrated levels of poverty and social deprivation. There is an obligation—this is where I agree with Mr Malthouse—that there is a moral obligation to address poverty, but I would also say that, as well as those big structural changes about our society, we need to also be focused on the here and now. That is very much related to the work that we are doing to invest in services and to reform services and to move matters forward as much as we can as quickly as we can. I am now going to bring in Eleanor Whitham, followed by Sue Weber. It has been argued that the high drug death rate in Scotland is partly a delayed health effect from the circumstances in the 1980s. How should current anti-poverty policies respond to that? Do we need to have more emphasis on whole community regeneration with the public health approach and wellbeing approaches right in the heart of our communities that will help to reduce stigma and support everyone, including those who are experiencing problem drug use? There is a lot in that question. I think that there needs to be a bit of care taken around the narrative of the 1980s. I always find talking about the 1980s some for triggering, but there is no doubt that there was a scarin effect of the 1980s. I suppose that it is something that we need to bear in mind as we did in response to the financial crash and the spike in youth employment. We knew that the rise in youth unemployment has a scarin impact on people's life chances. It is why we are following a recession or a pandemic that we need to, as part of recovery, be very much focused on reducing the risk of those long-term impacts on our society and our communities. The relationship between drug use and poverty is very clear. The annual report last year on the drug-related deaths statistics showed that you are 18 times more likely to die of a drug-related death if you are in our most deprived communities. Where I would always urge a bit of caution is that sometimes people look at the structural issues in and around poverty, and that can mean that they can feel quite helpless. We shouldn't feel powerless in the face of poverty—poverty, after all, is man-made. The work that we are doing around child poverty, for example, and our work in social security—the members of the social justice committee are not going to go through all those things in detail. If I can point to one example—not just because I introduced it—that the fairer Scotland duty, which means that all public agencies in terms of the allocation of the resources and those big strategic decisions need to have at their heart the drive to reduce poverty. I hope that I have answered almost what I am expressing. The point about regeneration is really important, because although we look at our child poverty action plan, the focus on the evidence is on things like income, work and reducing the cost of living. The first child poverty action plan, which will be updated soon and again—that was the work that I was involved in—was also looked at the impacts of drug use, particularly in families, but also about quality of life. The role of community regeneration is really important because it is often about community action, but it is also about resilience of communities. As a member of the prevention review group, I understand the clear need to prevent homelessness from occurring in the first place. I am glad to see the public consultation underway on the prevention duties. Minister, like me, do you recognise the need for wider public bodies to have a duty to ask and to act when it comes to preventing homelessness, working across departments and sectors to support individuals and families? How do you see that approach helping to reduce drugs deaths and the devastation that they cause? I have recently had some meetings with Ms Robison about the strength and homelessness prevention duties. I think that there is something very simple, powerful and fundamental about asking and act, because what it should not be is that you ask somebody and then that you act by referring them on, and that will be appropriate times. However, in that whole philosophy of asking and act, it should also be about how you can act before you refer someone on as well. It is culturally important in that sense of ownership and more collegiate work across the different workforces. I am looking very closely at the work that Ms Robison is leading, because I think that there is something very important that we could learn from and perhaps implement in and around drugs policy. It connects with the math standards, but it is about how we make people's rights real and in reality. I am going to bring in Sue Vibber now, followed by Faisal Shawdry, who is over to you. Thank you, Audrey. I have a couple of questions for the minister. Since the introduction of the recorded police warning scheme, which effectively decriminalised class B and C drugs, the number of admissions to psychiatric hospitals for cannabis users has increased by 74 per cent. In light of that evidence, does the minister still support the policy and its retention, which effectively decriminalise class A drugs? Yes, convener. I continue to support the use of recorded police warnings, which were extended recently in relation to class A drugs, which are heroin and opioids. Essentially, it is a discretion that police have. Again, it is based on the wealth of international evidence that our justice system, at every twist and turn, needs to be providing opportunities to divert people away from the criminal justice system into either diversionary activities or indeed treatment. I know that Ms Webber and I have a fundamental disagreement around that. I think that we have common ground around the increase in hospital admissions around cannabis. Although cannabis is rarely implicated in drug-related deaths, as we have seen from various statistics, it features heavily in hospital admissions and psychiatric admissions, which is often due to the synthetic cannabinoids. That relationship between cannabis use and mental health is a point that we would agree on. The increase in hospital admissions in relation to cannabis is across all ages, but there are also some concerns that I have in and around young people. Young people have different patterns of drug use. We know that most young people and young people are increasingly moving away from risky behaviours, but for those young people who use drugs, they are far less likely to be using opiates, and it is more likely to be cannabis, or maybe MDMA or cocaine. We have work that is on-going about ensuring that we can develop services that are more bespoke to young people. That also feeds into the work that we are doing around the prevention material to reach young people, not just in schools but young people, in and out with schools. However, the reason why we have a national mission is to consider the harms and risks of all drugs and the best way to reduce those harms and risks. That, as I suppose it is very nub, is often about getting more people into the right treatment at the right time. My apologies for the words of that answer, convener. Thank you minister for that reply. I suppose we have had a very productive few sessions with our joint committee, and I suppose my recollection of yesterday's with Mr Mawthouse might be a little different to others. I felt that it was quite collegiate, and he was always extending and seeking to work collaboratively with your minister, and that is exactly it. However, I am concerned that with some of the questions today and the focus that we have had, in particular from the SNP members and the Green Government, that the whole argument in positioning of the consumption rooms is just now there to stoke a grievance and create something that can be used to prevent us tackling and adopting new policies and tactics that we can do now to stop people from dying. Would you have a comment on that, minister? I would say that it is often important that you work harder to engage with those whom you disagree with. It is no secret that Mr Mawthouse and I have a different perspective in and around implementing a public health approach, and we have different perspectives around some harm reduction interventions. Safer drugs consumption facilities being just about one. However, in all fairness, I have had a number of discussions with him. There have been a number of meetings on a four nations basis, such as the British Irish Council or the UK drug summit that I participate in and engage in, and we have had lots of correspondence. Yes, I am a persistent co-responder to Mr Mawthouse, but my ethos is to engage him and his Government on the evidence. My correspondence to him on safer drug consumption facilities has always been about the evidence that those work. What has been useful about our more recent correspondence and, I suppose, Mr Mawthouse's appearance yesterday, is that he has spoken more and in more detail about what his concerns are. That gives me the opportunity to refute concerns around the evidence, because the evidence in my view is crystal clear. I can point to evidence across the world, evidence produced by other experts as well as our own evidence paper. He sees more obstacles to implementation than I do, but if there was a way for us to work together to overcome any obstacle, I would have an open door to that. My stress is that I seek to engage in the evidence and not the politics. In November, the Scottish Government published a survey result from residents residential rehabilitation providers in Scotland relating to a pathway into and out of residential rehabilitation. One concern raised in the survey was that homelessness services have pressure to reduce figures and that those who are homeless in residential treatment are still passed as homeless and may need to leave earlier than advice due to homelessness sector pressure to lower numbers. It is unclear from the survey if that is a localised issue or if it is a wider problem. Has the Scottish Government investigated that concern in more detail? If so, what were the findings and has any action been taken to address the concerns, given the potential and adverse impact of those receiving care? I really appreciate that question because there are a number of issues around residential rehabilitation. I am committed to taking a balanced approach to securing a whole system of care. Residential rehabilitation is an important part of that. It has historically been supported and funded less, and the Scottish Government is now seeking to address that. As part of the statement that I made to Parliament, it would have been November last year. There was a whole suite of information that was published. Some of that information was published to shine a light on where things were not operating as they should be. However, as part of that suite of information, it was also about the work going forward to improve access to funding and to improve those pathways and to ensure accountability with the Government, but also accountability at a local level so that people could see where the funding is going and how many placements were being funded by ADPs area to area. I know that the pandemic had an impact on some services. I am not sure if I have picked Mr Sheldrape correctly. I am not sure of any on-going concerns, but the residential rehab development working group continues to raise very closely with residential rehab providers. There are issues that I am very proactive about. That is why there is a housing support fund to ensure that people do not have to choose between maintaining their tenancy at home or going into residential rehab. That is to mitigate some issues around the rules of how the rules of housing benefit were implicated. I hope that that answers Mr Sheldrape's question. I hope that I have picked it up all correct. Thank you very much, Faisal. I will hand over to Gillian Martin and then I will bring in Miles Briggs. Gillian Martin is about drug treatment for people who require it. First of all, I want to ask if there is any indication or estimation of the number of people out there that might not be in treatment who could probably benefit from it. What are we doing and what is the Scottish Government doing with partners to improve and expand the capacity for a range of treatments? The minister will know that I have a particular interest in treatments for people who have caring responsibilities and that there has to be alternatives for people who fit in with those responsibilities. Some of the work that we are actively engaged in just now is updating prevalence. We need to update our understanding of the extent of prevalence of drug use in our society. There are some existing data, and I recently announced some funding just before Christmas to update that. We need to understand more about prevalence in Scotland. The reason why that is important is crucial information to introduce our treatment targets. To answer Gillian Martin's question directly, we do not have enough of our people in treatment. That would be a very fair critique. We do not have enough of our people in treatment and we do not have enough to retain people in treatment or to follow them up if they fall out of treatment hence our investment in things such as non-fatal overdose pathways and outreach. The new treatment target will be crucial and indicators that underlie that in terms of improving and scrutinising the numbers of people who are in treatment. As I said to Parliament before Christmas, we will bring forward and publish and announce that in spring this year. Much of our work around mass standards and residential rehabilitation is about not just improving the ways in which we work but also increasing capacity. There is also an important point here about workforce capacity. We are undertaking work right now in terms of mapping the shape and size of the workforce to identify gaps, to look more at training needs. There is an issue of stigma that is very pertinent to the workforce quite often. The workforce can feel quite stigmatised too. We will look at a recruitment campaign and all of this has to be joined up with other big national workforce strategies across Government as well. Thank you very much. I want to follow up on my wider family's point. A range of work has been done to support families who might have members of their family who have problems with drug use. Can you expand on some of the things that have been done there? Absolutely. We are trying to get a Belt and Braces approach with us. The one hand is part of our new funds that are available to stakeholders and third sector organisations. There is a very specific children and family fund for services and third sector organisations to apply for direct funding from the Scottish Government. That is managed via the Cora Foundation. Those direct funding opportunities have been very popular. There is also the We Published Before Christmas family approach framework. That came with a funding package for ADPs. All the evidence at home and abroad indicates that we need to be supporting families as a whole but also as individuals, be it children or parents. We know that for everyone who has a drug or alcohol problem, there is an impact on 11 other people. Families are absolutely crucial to that. Supporting families and where possible keeping families together is crucial. Family involvement in an individual's treatment needs to be considered an appropriate option and choice for the individual. That is about both services and some do that very well, working with the family as a whole better as well as serving the individual needs. The announcement that we made last year around our national family residential service will support up to 20 families at any one time. That is part of our work to keep the promise. I will not go into detail on less press, but the work of the promise is highly germane to the work that I am doing. We also need to have better standards of service for women and more bespoke services for women, because that has been a gap. While it is mostly men who lose their lives, we are seeing that increasing women losing their lives is rising at a disproportionate rate. I will now bring in Miles Briggs and then Pauline McNeill. I wanted to ask a few questions with regard to the Lopsone programme and Community Pharmacy Scotland, because we all support that. It could have made a difference. I have been frustrated to see where the work of the task force has not really taken that. I wanted to ask you specifically two points. Why is it that the Lopsone is not included on the national supply line through Pharmacy First for people for pharmacists to access it? Specifically, in terms of the recommendations from the task force, why has a single record for patients not been developed given the public health emergency and given the potential improvement outcomes that that could deliver? There are three aspects to the question. Let me deal with the devolved aspect first, because it is a reserved aspect. The bit about single records that need to be addressed is well made. I have met community pharmacists and the Royal College of Pharmacists. They rightly point out that, with better linkage of records, they could be doing more, and that is something that my officials have raised with the chief pharmacist in health division. I absolutely accept that point. The pharmacists are absolutely correct to raise it. I want to see a resolution to that, because I think that there is much more that pharmacy services can build from the table here. That is where it also takes us to issues in and around the Lopsone being registered as a controlled drug, and that is where our engagement with the UK Government is important as well. If the Lopsone is classified differently and there are different options, it could be part of a pharmacy service in the way that you can have an individual consultation with a pharmacist over a range of medications. You could do that with the Lopsone, particularly the one that involves a needle. However, there is also an argument that the pharmacists make in terms of nasal Lopsone. If that was reclassified, that could be distilled in the chemist in the same way that you do by decongestion. That would require some changes at a UK level. I think that that would help in terms of widening the distribution and acceptance of the Lopsone. I suppose that, over and above that, the task force has done really good work in this area. In terms of the reach of the Lopsone, it is up to about 59 per cent. If you want a technical explanation about how that has worked out, I will probably hand you over to tomorrow's phraser. However, as a result of our Lopsone campaign, there have been 4,000 kits distributed. I think that the work that Scottish families have affected by alcohol and drugs in terms of that click and deliver service is first class. The work that the priests are doing at Scottish Ambulance Service has given out 1,000 kits that they announced. Their work is also really relevant, not just in terms of distributing take-home Lopsone kits but also connecting people to services. I think that the task force has done good work in and around the Lopsone. I think that there is more to do with the pharmacy. I also think that there is more to do in terms of the Lopsone, which has now become available in prisons prior to release. However, there is also much more that we can do in terms of mental health services. There are areas of improvements, but your point about pharmacies is well-read. One of the things that would be really helpful is any update on timescales around that. On my work when I was a member of the health and support committee, I think that we understood that this would be moved forward quite quickly. Especially the opportunity to have some sort of traffic-like warning system for patients just does not seem to have materialised. I hope that that is genuinely going to become a priority and we see that move forward. I wanted to move on to reviewing treatments available. I know that I have been in correspondence with you on that for some time, but whether we are looking at the potential of the treatments available around NET and things like that and genuinely for people to feel that they can take decisions around what is best for them and their families at where they are in their addictions. Where that can support their personal decision-making and impairment as well, and just where the Government was on with some of that workstream as well. So, convener, if Mr Briggs wishes in terms of his latter point that we are on track in and around developing our public health surveillance system, building on the kind of warning systems that exist so that this is kind of broader than a traffic-like system or the distribution of naloxone. We are also waiting to hear the results of the UK-wide consultation on naloxone, but we will certainly never meet Mr Briggs and, of course, the committee is involved and informed as well. In terms of treatments, again, treatments that are based in evidence are absolutely crucial and have to be a priority. Notwithstanding that, if you take the NET, we have corresponded with Mr Briggs on this and pointed people in the direction of the chief scientific officer in terms of how you pursue things like trials. The fundamental point that Mr Briggs makes about informed choice is an absolutely core part of the medication assisted treatment standards. People like all patients who receive a healthcare service, we come to an informed choice and we are supported in coming to informed choice by clinicians and practitioners. People should be able to make informed choices around medication assisted treatments, but also other types of treatments. Of course, the whole purpose of MAD is to make that connection between the options and possibilities around phartramacutical interventions and psychosocial interventions. The point that he makes about us having a balanced approach and implementing what works, not just in terms of the evidence but also what meets the needs of individuals, is important. Pauline Cynwys, can we hear you? Sorry, I just cut out for a second. Can you hear us? Yeah, thank you very much. Good afternoon minister. I hope that it goes without saying that I realise that the challenge is a huge one and that it's a very complex one. I have an interest in the overdose prevention safety issue because I have hosted Nana Gorffyddson, who is a street lawyer from Denmark, who has pioneered the whole policy in Denmark and has been influential in the debate here. There has been quite a bit of exchange on this, and you probably heard the minister yesterday. My first question is one of the things that came across. I think it's actually Gillian Martin's line of questioning. It seemed to come across that he was concerned that he would send out the wrong message. Shall we review the 9721 act and include even the ability to pilot these in that act? He was concerned that it would send out the wrong message. I just wondered whether you wanted to respond to that. I'm very aware of Ms McNeill's work in this area. Frequently, I meet stakeholders who talk about her work and the events that she's hosted in the past. In terms of the comments made by Mr Malthouse about some of the services such as safer drug consumption facilities giving out the wrong message or encouraging drug use, there is just no evidence of that. You do hear people verbalise that concern, but there is just no evidence. There is evidence to show that safer drug consumption facilities reduce overdose deaths and the safe lives of the blood-borne viruses that reduce infection to wounds and improve wound care. They can also help to reach people who inject drugs who might not otherwise engage with services or be visible to services. Because much of that—Ms McNeill is a Glasgow MSP—much the campaign and coalescent around safer drug consumption facilities came through. There is a community benefit to that as well in reducing drug-related litter and drug use in public places. There is evidence that they work and evidence about the benefits. It's not a silver bullet, but nothing ever is. I just think that we need all of the options. I have used the misuse of drugs site, but we want to have all of the options to help us to address the national scandal and the national crisis. The minister went on to say that he thought that there were complex questions that needed to be answered if we legislated in this way. I recognise that, ideally, our form of the 1971 act would be best positioned for other reasons as well. As you say, minister, it's not the silver bullet, nothing is. However, the Lord Advocate is on record saying that she will consider this question as to whether or not it might be in the public interest. My question is, I guess, that it will be complex for any Lord Advocate to make a decision about whether or not in the public interest he would not prosecute under the 1971 act in certain areas if it was a public health issue that prevented deaths. I suppose that question is twofold. One, do you think that these complexities can be overcome? If the Lord Advocate who has yet to make a decision makes one in that vein, I suppose that it would negate the immediate necessity to reform the 1971 act because it would have the same effect or would it? There are a number of issues there, convener. I hope that you will give me a wee bit of latitude and answer all of that properly. My view would be that it is nearly as old as me. It is written for another time. A lot of the evidence that the task force gathered, people feel that it is rooted in that drug use is all about personal failings and the need for punishment. A routine branch review is needed. In my view, it impedes that public health approach. Other people might argue that it is completely contradictory to a public health approach. It impedes not just worker and safe drug consumption facilities, but other harm reduction work, as well. There are some examples that I can give with that, if need be. The Lord Advocate made a very clear statement to the Justice Committee last year in saying that she would be prepared to reconsider what was in the public interest and to reconsider another application, but she also scoped out what needed to be addressed and considered. She spoke about the need for evidence. I think that that is the most straightforward part. I think that the evidence is a clear cut. She also spoke of the need for detail and precision. All the partners needed to be on board, and that included the police. That is why we are working across all those boundaries. There are issues and complexities. I am not going to make any bones about that. I will not repeat the correspondence that I said to Mr Malthouse, but he sent me. However, I think that you will see what his concerns are and that many of them can be rebutted. Nonetheless, there are issues around how that is policed in and around the vicinity. It is also the need for us to be working through all the potential scenarios with our partners. We need to be looking in detail at the operating procedures, staff training and the service user information about what is permitted and what is not. That is detailed, precise work. There are difficulties around it. It would be easier if the UK Government legislated or devolved powers. I will continue to pursue that on the basis of the evidence. Equally, what I am more invested in is doing absolutely everything that we can to find our own solutions with regard to that. If the police are content and the Lord Advocate is content, if we can get to that position, we will still be at it. Thank you very much, Pauline. We are almost at the end of our session. It has been a long but very informative morning. However, if I ask for members for guidance and perhaps ask one more very quick question before you go, that is on the national collaborative. Obviously, we are aware of the announcement recently regarding the national collaborative. I want to ask you to make a few points about the remit and the purpose of the collaborative and how it might work alongside the task force, which also has members with lived experience contributing to its work. I am really excited about the national collaborative. I was committed to bringing that forward. In part, due to my experience in social security and the work that we have done around lived experience there and experience panels, but also from my previous days in education, we have seen the benefits of the early years collaborative. I think that it is absolutely crucial that there is a vehicle that is owned by the voices of experience that are there. I am delighted that Professor Miller, Scotland's leading human rights expert, has agreed to share that. He comes with an independence. He is well placed to understand the impact of trauma, for example. He has done previous work with survivors of in-care abuse, where he was able to bring forward a programme of work and amplify those voices and voices that ensured that change happened, particularly in the redress scheme. I am confident about the national collaborative. Professor Miller is now engaged in a series of engagements, introductory meetings and one-to-one meetings with the sector and people with lived and living experience. He will work with them and bring forward a programme of work with milestones and timescales. That is an important part of the national mission, because we need to ensure that those voices of experience are plugged into every aspect of that national mission. It is also about enabling those voices to inform and drive change and to be informed by a human rights approach. Thank you very much, minister, for that helpful update, and we very much look forward to hearing more about the progress of the collaborative. That completes our evidence session this morning. I would like to thank you very much indeed ministers and your officials for attending this morning. Of course, if members have any further questions, we will follow those up in writing, so many thanks again. That concludes the public part of this meeting, and we will now move into private session and on to MS teams. Thank you very much.